Surgical Center for Dental Professionals of NC LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

812162341 Issued in NC

Legal business name

SURGICAL CENTER FOR DENTAL PROFESSIONALS OF NC LLC

Practice address

2620 New Bern Ave
Raleigh, NC 27610-1821

Phone

(919) 225-6899

NPI assigned

Apr 26, 2017

Last updated

Aug 11, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Uday N Reebye

Title

Owner

Phone

(919) 932-4425

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1932634029. Details of each certification follow.

• CCN 34C0001202 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 34C0001202

Legal name

SURGICAL CENTER FOR DENTAL PROFESSIONALS OF NC LLC

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Oct 25, 2018

Last certification

Oct 25, 2018

Ownership / control type

Proprietary

Facility address

2620 New Bern Avenue
Raleigh, NC 27610

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Surgical Center for Dental Professionals of NC LLC

  dba SCDP Anesthesia Professionals

  • Anesthesiology Physician
  • Raleigh, NC
  • NPI 1821555020

  1153662002

  Same PAC ID

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Surgical Center for Dental Professionals of NC LLC

  dba SCDP Anesthesia Professionals

  • Anesthesiology Physician
  • Raleigh, NC
  • NPI 1821555020
  NPPES parent name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1493164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597104000000",
    "number": "1932634029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9650 STRICKLAND RD",
            "address_2": "SUITE 103-177",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276151902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 NEW BERN AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101821",
            "telephone_number": "919-225-6899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL CENTER FOR DENTAL PROFESSIONALS OF NC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-26",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A",
        "authorized_official_last_name": "REEBYE",
        "authorized_official_first_name": "UDAY",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-932-4425",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NC",
            "license": "812162341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kawanjit Surapur, MD
• Rajini Surendra, MD
• Sruthi Suresh
• Suresteps Inc
• Surgical Center for Dental Professionals of NC LLC (SCDP Anesthesia Professionals)
• Amanda Marie Surguine, PTA
• Dnadia Myaja Surles, MSW, LCSWA
• Emma Joelle Surles, RD
• Morgan Faith Surles, PHARMD
• Survivor Friendly, LLC

• Ambulatory Surgical Clinic/Center in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Ambulatory Surgical Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.